NPIMap

Organization Active NPI

Bodzin Chiropractic Professional Corporation

  • Chiropractor
  • San Diego, CA
National Provider Identifier
1710005541
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC23213 Issued in CA
Legal business name
BODZIN CHIROPRACTIC PROFESSIONAL CORPORATION
Doing business as
Chiropractic Wellness Center
Practice address
6030 Santo Rd
D
San Diego, CA 92124-1196
Phone
(858) 541-0505
Fax
(858) 541-0527
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Miles I Bodzin, DCNPI 1982696142
Title
President
Phone
(858) 541-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC23213 CA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X DC29627 CA

Addresses

Primary practice location

6030 Santo Rd
D
San Diego, CA 92124-1196

Mailing address

6030 Santo Rd
D
San Diego, CA 92124-1196
Phone (858) 541-0505

Other names 1

  • Chiropractic Wellness Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710005541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 SANTO RD",
            "address_2": "D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241196",
            "telephone_number": "858-541-0505",
            "fax_number": "858-541-0527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 SANTO RD",
            "address_2": "D",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241196",
            "telephone_number": "858-541-0505",
            "fax_number": "858-541-0527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODZIN CHIROPRACTIC PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BODZIN",
        "authorized_official_first_name": "MILES",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-541-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC23213",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC29627",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chiropractic Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.